- Think about the possibility of giving oxygen through the PEEP valve. Request for consultation - Have a doctor of the NSR or a doctor on duty at a polyclinic or hospital in your region according to instructions - To determine the tactics of assistance - The medical level team should be able to recognize by ECG signs of ischemia, heart attack and life-threatening rhythm disturbances.

* The tactics of providing assistance are specified in case of detection of an ischemia or myocardial infarction on the ECG

- At the slightest doubt when interpreting the ECG and always before you start TLT, you should get a doctor's consultation.

- The patient can not be hospitalized, if all, the conditions listed below are taken into account.

- There is a stable angina, an attack of pain does not differ from those that occurred earlier.

- The attack is stopped by no more than three doses of nitrosprey. No pain at the moment.

- Indicators of vital organs are normal.

- ECG does not reveal signs of ischemia.

- The patient is informed how to act in case of resumption of pain.

Transportation and place of hospitalization

- The basic principle: the patient should be taken to the hospital of the final treatment site if possible.

- The place of hospitalization is determined by regional standards.

- If the medical level team can not arrive on time in a timely manner, the basic level team begins transportation on its own as soon as possible.

- Without the waiting time for the team of the medical level, the standard time of call is not more than ten minutes.

- Always, if the patient has a change in the ECG, indicating a myocardial infarction

- If pain persists and there are disturbances in the function of life support

30.56 Balloon angioplasty 704

- Consider the possibility of balloon angioplasty if

* in your region this is done

* the patient has contraindications to trobolysis

- If you are taking the patient to balloon angioplasty, give the patient ASA and enter 30 mg of kleksana IV.

* In addition, you can inject a patient with RhoPro and / or Plavix, if this is agreed in your area.

* The ECG changes that indicate myocardial infarction should be ascertained by the doctor

More than 3 hours after the onset of pain

- Consider the possibility of balloon angioplasty

- Thrombolysis is not performed if the doctor has not decided otherwise

Less than 3 hours from the onset of pain

- Consider the possibility of balloon angioplasty, if this intervention can be done

* sooner than an hour later, and thrombolysis - later

* less than 90 minutes after arrival to the patient

- Consider the possibility of balloon angioplasty, if thrombolysis is not effective